Enloe-Whitaker, Suzanne Ellen

Enloe-Whitaker, Suzanne Ellen is an individual health care provider with primary practice located at 1700 North Waterman Ave , San Bernardino CA 92404-5105. She recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as her primary health care specialty. Enloe-Whitaker, Suzanne Ellen can be contacted via phone (909) 883-8611.

Contact Information

Primary practice address
1700 North Waterman Ave San Bernardino CA 92404-5105
Phone: (909) 883-8611
Fax: (909) 886-1798
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 20A7535 California

Profile Details

NPI number 1720058415
LBN Legal business name Enloe-Whitaker, Suzanne Ellen
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Mar 11th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720058415 NPPES
California MEDICAID 00AX75350

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